SWL outcome in artificial hydronephrotic vs. non-hydronephrotic kidney for preschool children with high-density renal stones.

OBJECTIVE

To assess the effect of artificial hydronephrosis on the result of shock wave lithotripsy (SWL) in preschool children.

MATERIALS AND

METHODS

A prospective randomized trial was performed between January 2013 and January 2017 with 300 pediatric patients, having kidney stones with a size of 1-2 cm and a density of 750-1100 HU. The patients were randomized into two groups: group A, in which a ureteric catheter was fixed and artificial hydronephrosis was performed by fluid irrigation prior to SWL, and group B which did not undergo hydronephrosis. SWL outcomes were compared between two groups.

RESULTS

In total, 153 cases were assigned to group A, and 147 cases were assigned to group B. Regarding demographic data, there was no statistically significant difference between the two groups. There were also no statistically significant differences in the number of shocks and energy power needed for each group. The results of SWL after the first session favored group A with a stone-free rate (SFR) of 90.8% vs. 75.5% for group B. The SFR after SWL was significantly in favor of group A (94.1%) vs. (86.4%) for group B.

CONCLUSION

The use of an artificial hydronephrosis technique to make interface around the stone improves stone-free rate and decreases the need for retreatment after SWL.